The proposed project creates and proves an innovative wheelchair accessory, SAFESLIDEBOARD. SAFESLIDEBOARD is superior to currently available transfer boards that require use of both hands for the following reasons: (1) SAFESLIDEBOARD is an attached component of the armrest reducing the risk for falls that occur when the standard transfer board slides off the wheelchair or transfer surface;(2) Transfers can be performed by individuals with limited hand use, weight shift, and cognitive awareness to set up and transfer independently;and (3) SAFESLIDEBOARD is vertically secured directly under a flip back armrest (developed in Phase I) instead of being stowed behind or on the lap of the wheelchair user and thus cannot be dropped or misplaced. The proposed project supports the mission of the National Institutes on Aging by developing/refining technology to address "Special problems and needs of the aged," particularly aged individuals with impaired mobility and hand use. The proposed Phase II project has a developmental phase, year 1, and an experimental phase, year 2. The Specific Aims are to: (1) Develop new prototypes of retrofitting armrest transfer board for wheelchairs;(2) Determine the effectiveness of SAFESLIDEBOARD;(3) Determine health care provider satisfaction with SAFESLIDEBOARD using qualitative, structured interview research techniques;and (4) Determine marketing options for SAFESLIDEBOARD. During the year 1, developmental phase, the Phase I prototype will be redesigned and fabricated to be lighter, stronger, and suitable for multiple wheelchairs - based on Phase I results. Aim 1 will complete seven tasks that include redesign of the: (1) transfer board model, (2) armrest adapter(arm assembly) to fit the new transfer board, (3) rear landing apparatus for flip-back armrest;(4) armrest tubing;(5) front attachment/seat cradle (6) connecting rod and swiveling hinge assembly;and (7) beta prototype production and ISO testing. During the year 2, experimental phase, clinical trials (N=72, 36 wheelchair users and 36 healthcare providers) will compare SAFESLIDEBOARD to the standard transfer board for bed, tub and toilet transfers. The target population is individuals post stroke but will not exclude other individuals who have difficulty using a standard transfer board. A mixed design approach will be used: (1) Prospective, repeated measures crossover (ABB, BAA, AAB, and BBA) for Aim 2;(2) Qualitative for Aim 3;and (3) Survey for Aim 4. Wheelchair user outcomes include: assistance required, safety, and features. Caregiver outcomes include: ease of installation, preference, pre-installed versus accessory, site of installation (right/left or both). Data will be analyzed using within subject repeated analyses, controlling for covariates, for Aim 2, and qualitative analyses based on grounded theory for Aim 3, and descriptive statistics for Aim 4, The projected Phase II end result is a market ready transfer device that passes ISO standards for a wheelchair armrest. PUBLIC HEALTH RELEVANCE: One of the single most important factors allowing older adult wheelchair users to stay at home, living independent of caregivers, and free of debilitating injury, is their ability to transfer to and from their wheelchairs safely. Transfer boards, which are boards upon which the user slides into and out of their wheelchair, are often misplaced, difficult to set up and free to slide off of the wheelchair to cause falls. The purpose of this project is to develop easily installed flip back armrests that can be lowered with one hand to be used as attached transfer boards that never fall or get misplaced.